Overview of the Epidemiological Profile and Laboratory Detection of Extended-spectrum Beta-lactamases.
From: Department of Pathology, Roy J. and Lucille A. Carver College of Medicine, University of Iowa, Iowa City, IA, USA. michael-pfaller@uiowa.edu
Clinical infectious diseases : an official publication of the Infectious Diseases Society of America
- Publish Date: Apr 2006
- ISSN: 1537-6591
- Volume: 42 Suppl 4
- Issue:
- Pages: S153-63
- Medium: Internet
- Language: English
- Citation (JAMA): Pfaller Michael A, Segreti John, et al. Overview of the Epidemiological Profile and Laboratory Detection of Extended-spectrum Beta-lactamases.. Clin. Infect. Dis. Apr 2006;42 Suppl 4:S153-63
Abstract
Extended-spectrum beta-lactamases (ESBLs) are plasmid-mediated bacterial enzymes that confer resistance to a broad range of beta-lactams. They are descended by genetic mutation from native beta-lactamases found in gram-negative bacteria, especially infectious strains of Escherichia coli and Klebsiella species. Genetic sequence modifications have broadened the substrate specificity of the enzymes to include third-generation cephalosporins, such as ceftazidime. Because ESBL-producing strains are resistant to a wide variety of commonly used antimicrobials, their proliferation poses a serious global health concern that has complicated treatment strategies for a growing number of hospitalized patients. Another resistance mechanism, also common to Enterobacteriaceae, results from the overproduction of chromosomal or plasmid-derived AmpC beta-lactamases. These organisms share an antimicrobial resistance pattern similar to that of ESBL-producing organisms, with the prominent exception that, unlike most ESBLs, AmpC enzymes are not inhibited by clavulanate and similar beta-lactamase inhibitors. Recent technological improvements in testing and in the development of uniform standards for both ESBL detection and confirmatory testing promise to make accurate identification of ESBL-producing organisms more accessible to clinical laboratories.
Mesh Headings (Keywords): Enterobacteriaceae, Enterobacteriaceae Infections, Escherichia coli, Escherichia coli Infections, Humans, Klebsiella, Klebsiella Infections, Microbial Sensitivity Tests, Risk Factors, beta-Lactam Resistance, beta-Lactamases
Check for Full Text / PubMed Unique Identifier (PMID): 16544266
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